Healthcare Provider Details

I. General information

NPI: 1346236148
Provider Name (Legal Business Name): DONALD E BROWN JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 12/02/2024
Certification Date: 12/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1381 MEDICAL CENTER DR
ROANOKE RAPIDS NC
27870-5130
US

IV. Provider business mailing address

PO BOX 640
ROANOKE RAPIDS NC
27870-0640
US

V. Phone/Fax

Practice location:
  • Phone: 252-536-5800
  • Fax: 252-519-0655
Mailing address:
  • Phone: 252-536-5844
  • Fax: 252-519-0154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number2010-00432
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: